NORTH MEDFORD HIGH SCHOOL SCHOLARSHIP APPLICATION

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1 Deadline: Thursday, January 28, 4 P.M. VIA SUBMISSION General Information: NORTH MEDFORD HIGH SCHOOL SCHOLARSHIP APPLICATION A. This application will be used to determine the applicants qualifications for any and all scholarships administered by North Medford High School. B. The applicant must be a senior on track to graduate from North Medford High School in June The applicant s academic achievement and involvement in school/community activities will be important considerations in the selection process. Other factors to be considered for some awards may include (but are not limited to) choice of school, intended major, specific activity involvement, and/or financial need. Any scholarship awarded by the committee must be used during the upcoming school year, with the student enrolling in nonremedial courses at an accredited college, university, or vocational school. C. In order to be eligible for consideration, an applicant must submit the following: Completed application Oregon CIS Activity Chart Names of two teachers willing to complete recommendation forms Name of North Medford High School (NOT CLUB) coach willing to complete recommendation form. Some scholarships require a recommendation. (Optional) MATERIAL SUBMITTED OTHER THAN REQUESTED WILL NOT BE CONSIDERED. Directions: Complete this application in its entirety. Legibility is essential. Submit your completed application and Oregon CIS Activity Chart as attachments to: brandee.tolner@medford.k12.or.us no later than 4 P.M., January 28. Late and/or incomplete applications will not be accepted. Be sure to verify your application was properly submitted to the College and Career Center. Scholarship Application/12/15/15/BT

2 Name: Address: Last First Middle Street Address City State Zip Code Address: DO NOT USE YOUR MSD Which college, university, or trade/technical school do you plan to attend? I have decided which school to attend (Name of school) I have not decided which school to attend. I am considering these schools: 1 st Choice: 2 nd Choice: College Financial Data (Complete only choice 1 if you have decided where to attend school.) (Complete both choices 1 & 2 if you have not decided where to attend school.) 1 st choice 2 nd choice A. The annual tuition to the school you plan to attend: B. Room and board estimate: C. Other expenses, books, fees, and transportation D. Total Cost of Attendance Accumulative High School GPA: Have you taken the ACT or SAT? ACT Score: SAT Score: Awards, recognitions, scholarships: List up to 12 in spaces below YOU MUST LIMIT YOUR DESCRIPTION TO THE SPACE PROVIDED.

3 Teacher Recommendations Please provide the name of two North Medford High School teachers who are willing to write you a recommendation: Teacher Name Teacher Name Coach Recommendation (OPTIONAL): Please provide the name of a North Medford High School coach who is willing to write you a recommendation: Coach Name Essay Topic: (Maximum 1000 Characters) Describe a role model who has had a positive influence on you. Include in your essay the characteristics you admire about this person and the effect this person has had on your life. Future Plans: (Maximum 1000 Characters) Please describe your future college and career plans in the box provided. Intended Major:

4 The specific scholarships listed below are only a portion of the scholarships available through this application and should ONLY be checked if you meet the specific criteria listed. IF YOU DO NOT CHECK THE BOX AND YOU QUALIFY YOU WILL NOT BE ELIGIBLE FOR THAT SCHOLARSHIP Anita Lipp Ponzoha Memorial: Female students who plan on a career related to life sciences Carolyn Newland Memorial/Medford Linebackers: Must letter in Track and Field senior year Christopherson Family Fund: Career and Technical education students in architecture, cabinet making and manufacturing engineering. Students must have passed on semester or more in the following areas: advanced industrial design, advanced woodworking, and advanced architecture. Clayton Vandarwarka Memorial: Senior Wrestler Must submit North Medford High School Wrestling Coach Recommendation Denise Anderson Memorial Wilson School: Must have attended Wilson Elementary School for at least one complete year Dr. Steven and Charlotte Wisely: Accumulative GPA of and overcome obstacle Kip Frostad Memorial: Students must have participated in school and community activities in grades 10, 11, and 12. High academic standing in math or science. Kiwanis Club of Medford: You must plan on entering a vocational related field (education that prepares people for specific trades or a professional position in engineering, accountancy, nursing, medicine, architecture, pharmacy, law etc. Kris Carey Memorial: Varsity football player Must submit North Medford High School Football Coach Recommendation Medford Education Association Future Teacher Award: Plan to major in education Medford Rotary Dan and Betty Snider Grant: Must plan to major education Medford Rotary Norris Perry Scholarship: Must be pursuing an education related to wildlife management or natural resources. PEO (Multiple Chapters): Female students who plan to attend college in Oregon or Cottey College in Missouri. Must be in top 25% of graduating class. Additional application required PEO interviews 8-10 students PEO Chapter EQ: Female students who plan to attend vocational/technical or community college. Oregon school preferred Robert and Leona DeArmond: Must attend either Southern Oregon University or University of Oregon Rod Rumrey: Football or Softball athlete Must submit a North Medford High School Football or Softball coach recommendation Sodexo Services: Preference given to students pursing Culinary or Hospitality courses of study Southern Oregon Lumberman s Association: Students families must work in the forest products industry (examples: forest service, BLM, lumber yard, forest fire work, replanting forests, log truck driver etc. NO CONTRACTORS) Vivian Coss Bateman Memorial: Female students that have participated in one or more Varsity level OSAA sanctioned sports Must submit North Medford High School Coach Recommendation West Family: Family income of $40-$80 and accumulative GPA of 3.5 +

5 Parent Income Information An important consideration of the Scholarship Committee is to provide financial assistance to students with identified financial need. The following information will help our committee in its decision. Some scholarships are based upon merit without regard to parent income. Your parents total income between (please check one): $ 5,000 - $ 20,000 $20,000 - $ 40,000 $40,000 - $ 60,000 $60,000 - $ 80,000 $80,000 - $100,000 Father s Occupation: Employed by: Mother s Occupation: Employed by: More than $100,000 FAFSA = FREE APPLICATION FOR FEDERAL STUDENTS AID FAFSA Expected Family Contribution (5 digits provided on FAFSA form): How many people live in your household (include any siblings under 26 that are not married or parents themselves who either live at home or are attending college). Are there any unusual medical or educational expenses, or special financial circumstances? Please explain here: Check here if either of your parents is a veteran of military service. YOU ARE SIGNING THIS FORM ELECTRONICALLY BY PROVIDING YOUR FIRST AND LAST NAME AND DATE OF BIRTH Applicant Name/Date of Birth Parent/Guardian Name/Date of Birth (Even if you are 18) I understand that my application is incomplete until I Brandee.tolner@medford.k12.or.us my application and my activities chart from Oregon CIS. Portal.aspx PRINT AND SAVE A COPY FOR YOUR RECORDS.